Managing Managed Care

Our inequitable, inefficient, oftentimes uncaring health care "system," revealed. -- Jeffrey G. Kaplan, M.D., M.S.

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My Patients ARE Sicker; They Need Extra Care!

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The common retort when confronted with the escalating cost of care and unexplained variation is: "But, my patients are sicker! Southerland, Fisher and Skinner in "Getting Past Denial — The High Cost of Health Care in the United States," are again observing their mentor, Jack Wennberg's dictum, written about extensively at the end of the last century and earlier, that the cost differences between regions and practices may be unwarranted.

Waste Less; Add Value

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To make health care reasonably profitable for private payers and more affordable for patients, those who manage health care must focus on reducing cost, which is far easier than increasing the health benefit or medical loss ratio.

The Business Opportunity of Medicine

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The practice is getting squeezed; Want ideas? First, don't give up on the idea that small practices are out.  Consider them, if for no other reason then they are often better then large pracices that are overly driven to see large volumes of patients. IOW, solo and small practices are still playing an important role, although they may require TLC to thrive.

The Managed Care-Pharma Interface-Part III: the Pitfalls and the Promise

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Medication Adherence and the Pharmaceutical & Med. Manufacturing (PMM) industry--an opportunity for synergism with health care. "At the same time that unprecedented progress in pharmaceutical research and development is producing new and better medicines for the treatment and prevention of disease – people are asking tough and legitimate questions about the role and responsibility of the pharmaceutical industry in expanding access to the results of this research."

Patient-Centered Caring

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Achieving patient-centered care is difficult, yet essential; since paternalism is out, the patient has a greater role to play. The editorial, "Patient-Centered Care; What Is the Best Measuring Stick?" by Drs.

Race to Health Info Tech--Tortoise or Hare?

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"Providers Believe Healthcare Reform will Increase Their Costs."  Here follow a few of its responses: 61% believe "electronic health records (EHRs) could have a positive impact on their businesses" 82% cited their biggest challenge in implementing HlT is cost. 17% of providers are or are planning to participate in a Health Information Exchange (HIE) over the next 12 months. 

Incentives That Can Make or Break Reform

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Our health care system is particularly inefficient and, for some, inaccessible.  As for the quality of care, by any measure it is variable at best.  Why is it so hard to fix?  Why do we pale in relation to most of the industrialized world?